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Post by Valerie & Lincoln on Oct 13, 2018 21:31:57 GMT -7
Lincolns Story My name is Valerie and I am the proud owner of two dachshund doggies, one with IVDD and one without. Kennedy is our newest family member he is 10months, he is a long-haired dapple chocolate pie and doing great so far. Lincoln is a Long-haired chocolate Dachshund, he just turned 5 years old in August and he also just have back surgery July 24, 2018. He had just reached his 3 month recovery mark post surgery. He weighs approximately 15 pounds and has always weighed about that much within his life. I have him a strict diet but the weight never seems to come off the lowest he has been is 13 pounds. His surgery was significant. One day he just couldn't walk, he did show signs of his IVDD in previous years but all the vets told me was to keep him off stairs and furniture. It was difficult because he was very active. The extent of his injuries prior to him not being able to walk were just minor pain and not acting himself. He had about 2 flare ups in his life prior to his extensive flare up that caused him to be partially paralyzed. I rushed him to the only neurology center we have in New Mexico and I opted for the surgery because he is still so young. 5 years with him wasn't enough for me and the thought of putting him down killed me. He was neurologically intact and the doctor said strict crate rest might help for a while but chances were he wouldn't get better without the surgery since he couldn't walk. I died a little in my heart and my soul. I knew we had a rough road ahead of us after this. I got an MRI and it showed just ONE area of concern T12-T13 left sided disk herniation. He had a significant herniated disk that would have possible severed his spinal cord had I not opted for surgery. His surgery was done the next day and he had to stay in the hospital for 3 days post operative for pain management and observations. He was on many drugs in the hospital some included fentanyl and ketamine for pain and sedation. He did very well at the hospital and then he was ready to come home. He was wobbly but functional with support and he was urinating on his own. He was sent home with carprofen 12.5mg every 12 hours for inflammation, gabapentin 1ml every 8-12 hours for pain, and tramadol 25mg every 8-12 hours for pain as well. He was on these medication for a few weeks we later added Trazadone 25mg every 8-12 hours for anxiety of being crated all day. He did as well as could be expected from a very active young dog. He has never received steroids. I crated him for 8 weeks, it was challenging but we did it, adding a little more activity each week after the 4th week. The first 4 weeks were strict kennel then potty breaks for 5-10 mins with a leash under his back legs to help him move around, then right back to the kennel. As we were getting close to our 3 month mark of recovery Lincoln was doing very well, he was running and playing with the puppy. He was cleared by his neurologist and surgeon for such play but they wanted it to be limited. I did so and he tolerated it well. I decided to take the dogs on a trip to my moms house in the 3rd month of recovery and Lincoln was doing well until he wasn't. I wasn't sure what was wrong but i knew something wasn't right. His back legs wobbly again like when he was in his first few weeks of recovery. Maybe he played too much, we were in the mountains, which he loved, he was running more than normal, he was excited. I kicked myself for bringing him, I blamed myself I thought all this recovery wasted. Now we had to start over again. I took him to the neurologist and they explained he was weak on his back legs but his neurological function was fine. They explained another 6 weeks of crate rest was in order along with more pain meds for 1 week. They warned me it could be another disk that herniated or just a flare up of his current injury. My heart sunk, I thought how could it be, he has been rested for 3 months with mild play and running. Is he so fragile he can't even play? I was angry I felt lied to, they said Only ONE area of concern. This disk took 3 years to herniate how could one herniate in 3 months while resting. I thought What kind of life am I giving my dog, what quality is this, locked away day in and day out, he looks at me like he is in trouble and sorry, he just wants out so he can chase his ball and play with is brother. [Moderator's note: please do not modify15 lbstrue crate rest only started as of 10/13gabapentin 100mgs 1x/day
tramadol 25mgs 2x/day] But I am currently crating him or keeping him in a small room while I am at work. He is working through it. Some days he's fine other days he seems weak on his back legs. My biggest fear is to wake up to him paralyzed again or worse. I have this anxiety, fear and sadness I live with everyday. I need some support to know there is light at the end of the tunnel, I am doing what the doctor says but I cannot afford another surgery nor do I want to put Lincoln through another one. He seems comfortable even when his legs are weak, he hasn't cried or yelped but his belly seems tight like he is in pain sometimes and I give him some of his gabapentin but I limit it because I am afraid of kidney issues. I am medical and know repercussions of pain meds, meds in general. It seems to help, I wish he could just tell me. He is eating and drinking fine, I must admit I will give him a treat because he is so bored in his kennel. Normal stools and urinating fine as far as I can tell.       |
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Post by Pauliana on Oct 13, 2018 22:05:36 GMT -7
YES, Lincoln CAN Have a Great Quality of Life!
Often, the question of quality of life comes up when a dog is diagnosed with IVDD. Are you struggling with that question right now?
Let us put your mind at ease, because your dog CAN have a great quality of life living with IVDD -- no matter whether the dog regains the ability to walk or not.
Quality of life is totally a matter of perspective. There is our human perspective; and then, there is the dog’s perspective – and they are as different as night and day. Our perspective is relatively complicated. By comparison, a dog’s perspective is surprisingly simple. A good quality of life for our dogs is:
Food and treats.
Safe, comfy place to sleep preferably with some blankets.
A family’s love.
It’s that simple. Believe it or not, how your dog gets from point A to point B isn’t a big deal and doesn’t factor into what makes him or her happy. Wobbly walking is fine; scooting is good; wheels are great!
No matter what level of ability your dog achieves after recovery, your dog will be happy and loving life as long as those three basic, but very simple, requirements of food, a safe, comfy place to sleep with blankets, and a family’s love are met. The real goal is being pain free. As long as your dog is pain free, he or she will move forward confidently and courageously never looking back, never having regrets, never questioning “why.” Dogs live in the “now.” They don’t worry about what happened yesterday or what tomorrow may bring.
Dogs don’t know pity. They don’t know “can’t.” They don’t understand “may never.” They don’t give up. They don’t get discouraged. They epitomize “where there is a WILL, there is a WAY.” They will find a way! They don’t give up easily or quickly. They move forward in life in the best way they can. They don’t care if they can walk again. They care about your love most importantly. OK, food ranks right up near the top too! To them each new day brings the promise of another opportunity to get MORE - more food, more treats, and more love.
Our challenge is clear: not to allow our perspective on quality of life to influence our decisions or cloud how we judge our dog’s quality of life living with IVDD.
Part of that challenge is to manage our fear and not look at the situation based on how WE would perceive things if it were to happen to us. We need to keep in mind what THEY value and help support them in their journey in life. Right now, your dog needs your support to help them become pain free and heal so they can resume their journey in life and the things they value in whatever way they can.
The definition of success in recovery for an IVDD dog can be explained by “PETS” which stands for Pain Free, Enjoyment, Treats, and Sharing.
PAIN FREE
Without pain, a dog is free to continue to get move forward in life being happy and fun-loving each and every day.
ENJOYMENT
They enjoy and embrace the sheer wonder of being alive. They enjoy with gusto every single morsel of each meal. They experience delight and unequalled joy with their ears flapping happily in the wind whether they are running on their 4 legs or their 2 plus 2 wheels. Their undeterred spirit and courage displayed in their enjoyment for life are unparalleled.
TREATS
Their joy of food or treats or the extra special treat of your hugs and kisses is incomparable and they don't have to be walking on all fours to appreciate those treats in life. They truly appreciate being alive to have whichever kind of treat another day.
SHARING
Living life to share love is paramount for a dog. The value of those snuggles and kisses are priceless to them and their little souls are filled by the love they receive and the love they give unconditionally in return. Love knows no physical limitations.
Dogs know it’s not important if they walk wobbly, scoot, or need a cart to fly.
They know to take life a moment at a time and enjoy it for all it has to offer. They know that the very best meal of the day is the one they’re eating right now. Perhaps we humans should look at life a little more like a dog does? A fun and loving quality of life is in the future for your IVDD dog!!
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Post by Pauliana on Oct 13, 2018 22:32:58 GMT -7
Valerie, welcome to Dodgerslist. All of us here know what you are going through, because we have experienced it with our own dogs. The thing to remember about crate rest is to have Lincoln close to you in which ever recovery suite works for him.. Pack and play, ex pen, stroller (as long as he is supervised).. There are many ways to make crate rest bearable. Please check out this link for ideas. dodgerslist.com/literature/CrateRRP.htmIVDD is rough, scary and upsetting.. Our surgeon told us to view Tyler as a fragile, precious treasure and we have done exactly that but he still has fun. Once he recovered from his surgery in 2013 and was released from crate rest, I watched him like a hawk worrying all the time.. As time went on, I could see he knew what he couldn't do anymore, so he never challenged the rules, about no stairs, no jumping up or down off of furniture, or rough play. He is happy regardless and he is still playful with his toys and we have lovely long walks now.. What was the start date of this current episode? Please list the medications Lincoln is currently on including their dosages and how often they are given? You are giving Lincoln the gift of crate rest so he can heal.. He is sad because you are sad. Let him know everything is going to be ok, because it will be. Don't think too far ahead, take one day at a time, just the way Lincoln does.. Healing thoughts and prayers. |
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Post by Julie & Perry on Oct 14, 2018 0:26:39 GMT -7
Hi Valerie, welcome. IVDD is tough, no doubt about it.
However, Lincoln takes his cues from you. As his pack leader you set the tone.
If you're positive and upbeat he will be too.
My oldest dog is almost 14 and was diagnosed with IVDD at 3 and had surgery.
Since then she's had quite a few episodes treated with conservative crate rest.
She still loves walks, treats, and snuggles.
You can do this. Read up on conservative crate rest. It's much stricter than after surgery but doable.
Hang in there. Healing thoughts and prayers to you both.
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Post by Valerie & Lincoln on Oct 14, 2018 6:58:09 GMT -7
Thank you all for your kind words of encouragement. My mind often does wonder if his quality of life is ruined from his IVDD. He was diagnosed with IVDD when he was late 2 he was almost 3 but I do not remember the exact date. I am currently giving him 100mg gabapentin once a day and then tramadol 25mg if he still seems in pain 12 hours later. I just restarted this 10/13/18 because he just recently started having pain again. Per the doctor she wanted both gabapentin and tramadol meds to be given together every 12 hours just for the first week then just do to one at night and one during day, then just as needed. It is difficult to keep him and the puppy separate they want to play so badly but I have noticed that Lincoln has learned his limitations, he rarely tries to jump on the couch and limits his rough play. I struggle with him running and jumping when I let him out especially when he feels better. I worry that he and his little brother will never be able to play again, that kills me because I actually got Kennedy so Lincoln could have a companion while I am at work. Will he always have flare ups throughout his life where I will have to crate rest him for 6 weeks? Will I always have to keep them separate until Kennedy grows a little bit and knows not to jump on Lincoln and rough house?  |
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PaulaM
Moderator. 
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,539
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Post by PaulaM on Oct 14, 2018 7:42:39 GMT -7
Valerie, if the vet thinks there is a current disc episode going on then, it will take 100% conservative treatment to: ---- let the disc heal with 24/7 100% STRICT rest inside of the recovery suite. Much stricter than for a post-op dog. Only out for a very few footsteps at potty time for a full 8 weeks. No couches, no laps--- just inside the recovery suite so that the disc can heal. Sounds like Lincoln can't heal his disc, continues with pain because too much movement breaks the scar tissue forming and the disc keeps on relapsing, keeps on having set backs. More information:http://www.dodgerslist.com/literature/healingdisc.htm ---- An anti-inflammatory on board to deal with the painful spinal cord swelling. Why is there no anti-inflammatory on board? More information: www.dodgerslist.com/literature/healingsweling.htm---- Pain meds given promptly on time more than likely every 8 hours in order to provide round the clock, dose to dose full pain relief. Pain meds have a short half life and that is the reason an Rx for every 12 is not likely to provide full managment of pain. More information: www.dodgerslist.com/literature/healingpain.htm--- A blood panel provides information on organ health. When is the last time he had one? What is your concern about his kidneys--- what past kidney issues has he had? Which medical field are you in? What is the name of the surgical center that did his surgery in July? We encourage learning about IVDD. Knowledge is simply the power to help and protect Lincoln by doing the right things to help him heal his disc. Knowledge gives you the ability to converse with a vet and understand what the treatment he is offering is all about. Ask good questions when things don't seem right. Know what to monitor for and call the vet when pain is not covered or if neuro functions start to diminish. I encourage you to check out all the buttons to be the IVDD savvy pet parent Lincoln will depend on for th health of his disc. Here is the link: www.dodgerslist.com/healingindex.htm |
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Post by Valerie & Lincoln on Oct 14, 2018 8:05:04 GMT -7
He had the surgery then he was fine it was just recently he had another episode. I work 8-12 hour shifts so it is difficult to give him meds every 8 hours unless I am not working. The gabapentin dose was increased from 75 to 100mg this last episode. I have him in a small room where is doggie door is so he can go in and out as he pleases for potty. I have cameras to check on him when I am not home. When I am gone he just sleeps and goes outside maybe once or twice to go potty. Should I just crate him the full 8-12 hours that I am gone for the 8 weeks instead of a small bedroom with access outside. I am a Flight Respiratory Therapist but do the work of doctors and medics because I transport neonatal infants in and out of the state, I am also a partial heart and lung bypass specialist (ECMO) so I know a lot about medications. Although I do practice western medicine I am a firm believer of eastern medicine as well, Lincoln gets lavender diffusion while being crated as well as soft music and dim cool area but I don't like giving him so many medications. Because I am so weird about it I just did a blood panel on September 20th and it was fine. I just am paranoid about his acquiring another issue due to medications. The neurologist wanted just the gabapentin and tramadol for now because he didn't really seem too painful. The only symptom of pain he shows me is a tight stomach when he rolls over to pet his belly. He does cry or yelp or have a hard time walking just crosses his back legs from time to time. I am looking into acupuncture for him, any thoughts? The center I took him to for his surgery is the only one in the state its in Algondones NM it is called The Animal Neurology and Imaging Center (ANIC). He has been seen by Dr. Debbie James [ACVIM] and Dr. Michelle Tensley [ACVIM]. I called today to ask about rimadyl but they want me to continue with gabapentin and tramadol. The chart stated that Lincoln mild discomfort of his muscles only, not his back so I think they didn't want to give an anti-inflammatory because he didn't "need" it. I have a pharmacy for him, literally but would like to limit it if possible. But I do not want him in pain either.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,539
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Post by PaulaM on Oct 14, 2018 8:33:29 GMT -7
Valerie, do you have a neighbor you can hire to give meds on time and check on Lincoln? The Doggie door thing does not meet the requirement of limited movement. So will change the start date of conservative treatment to today, Oct 14. Ideas to restrict movement of his back. --- change his recovery suite to an ex-pen. That way you can put a pee pad at one end for him to potty on. Not ideal but in your situation the better idea than use of a doggie door. Technically, Lincoln's recovery suite should only be large enough so he can turn around easily, and when lying down to fully stretch out his legs. His mattress should not have sides he has to jump in and out of or be too high causing him to have to jump in and out of it. Whatever you can do to abide by the 100% STRICT 24/7 limited movement of back and neck the sooner the disc can heal. When a patient is sick, then it is best to USE the meds needed. Any pain is not a good idea especially so IF, if this is a current disc episode going on. You are aware of the studies--- "Treating pain early usually brings quicker and better results. Healing occurs faster when pain is under control. Pain affects blood pressure, heart rate, appetite, and general mood. Until all the swelling is resolved on the inside via surgery or conventional medical treatment, there will still be a source of pain. Herniated discs, damaged spinal cord require a significant amount of time to heal. New tissue must be generated. Swelling must have time to subside. Pain is so important to the overall well-being of a patient that it has become the 5th cardinal sign of human assessment." (Philips DM. JCAHO pain management standards are unveiled. J.Am Med Association 284(4):428-429, 2000) Institutions can risk their federal funding if they do not routinely assess for pain.You know Lincoln best. New neuro diminishment of wobbly legs indicates something is pressing on the cord. The two neuros believe it is just a new muscle weakness not a new disc episode (flare up, bulging disc, and other names?)--- can you elaborate more about the neuro's thinking? To me their summary means this IS a disc episode going on! IT does not take 6 weeks for overdoing muscles to heal. If you ARE seeing pain, then it needs to be attended to with more frequent doses than once or twice a day. --- gabapentin 3x/day --- tramadol moved to a more aggressive dose in mgs for a 15 lbs dog 3x/day. 25mgs 2x/day is almost like not giving any! Let us know if you are seeing any of these signs of pain to help you confirm. Sometimes seeing two signs is helpful in confirming pain. Most dogs will not roll on their back if they are painful. SIGNS OF PAIN ◻︎ shivering-trembling ◻︎ yelping when picked up or moved ◻︎ slow to move ◻︎ tight tense tummy ◻︎ arched back, ears pinned back ◻︎ head held high or nose to the ground. ◻︎ restless, can't find a comfortable position ◻︎ slow or reluctant to move much in crate such as shift positions ◻︎ not their normal perky interested in life selves + pain from neck disc: ◻︎ looks up with just eyes and does not move head and neck easily. ◻︎ not eating due to painful chewing or in too much overall pain ◻︎ holds front or back leg flamingo style not wanting to bear weight
Look forward to your comments to help us better understand what Lincoln's situation, if this is a disc episode and the need for 100% STRICT rest 24/7 or something else. |
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Post by Valerie & Lincoln on Oct 14, 2018 8:47:06 GMT -7
I do not have anyone to help with medications I live 3 hours from family and have friends who all work the same time as me. I paid a lot of money during his initial healing time after his surgery to have someone come and give meds and let him out 2 times a day and now I have exhausted those funds. I also took the first week off from work for his recovery to get him in a better place. I am transitioning to a full time job as ECMO coordinator which should mean less hours to work in a day but more days to work in a week. I hope with this I can keep up with his meds better. The tight belly is only when he rolls over and he does keep his head down and sit more often than before his surgery. I will keep up with the ▲gabapentin to 3 times a day since it is 100mg and then call to increase the dose of tramadol to maybe 50mg every 8-12 hours if he still shows signs of pain.
[Moderator's note: please do not modify
15 lbs
true crate rest only started as of 10/14
gabapentin 100mgs 2x/day not giving 3x/day
tramadol 25mgs 2x/day]
I have transitioned him to the crate now, I put a flat mattress in there with his water. He will not pee on a pad he never has, he usually just holds it until I get home. He was kenneled as a puppy for several months so he is used to the crate. Thank you for the information, I will try this and see how it goes.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,539
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Post by PaulaM on Oct 14, 2018 9:47:36 GMT -7
Valerie, you are moving in a better direction to help his disc heal!
As far as the pee pad, how about some extra inspiration. Could you collect some peed on bit of grass from another dog. Once he has peed on the pad, then you can save a couple of inches of the soiled area in a zip lock bag. When you leave for work, place the soiled piece on his pee pad...maybe he'll get the idea it is ok to pee there?
As far as acupuncture, laser light therapies, the most important care you can give in a mild case is to stick with strict rest and avoid risky to the disc transports to vet visits. If there is pain, then pain meds need adjusting.
I would be good if you can get clarification from one of the neuros. If disc related and not sore muscles, then swelling is the reason to have an anti-inflammatory on board. Anti-inflammatory is used only until all painful swelling is gone. Usually somewhere in the range of 7-30 days. Pain meds are to provide comfort til the anti-inflammatory has completed its job. The test to know if all swelling is gone is the stop of the anti-inflammatory and the stop of pain meds. It is all guess work as to how long to use an anti-inflammatory.
Rule of thumb
pain = swelling = back on anti-inflammatory , pain meds and Pepcid AC
no pain when off all meds= just finish out all 8 weeks to let the disc finish forming good scar tissue.
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Post by Valerie & Lincoln on Oct 14, 2018 10:19:57 GMT -7
Ok I am doing what he was prescribed initially 100mg gaba every 12 then tramadol 25mg every 12 as well. He seems comfortable with both of these on board. I will reassess to see if I need to give it every 8 instead of every 12. I will take him to the neurologist if I see more discomfort to adjust those medications. I also have a 12 day supply for pernidsone he never got because he had surgery instead. It is good until January 2019 so I have that if I want to start an anti-inflammatory. The neurologist did say that would be an option if the pain and weakness doesn't subside. Thank you for your help...!!
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,539
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Post by PaulaM on Oct 14, 2018 10:28:09 GMT -7
It is pretty typical that vets will make medication changes when the owner calls them with updates. Transport to and from the vet can be risky for a dog on conservative care with the potential for too much movement of the spine and pressure to the weak early healing disc. Holding head down and reluctance to move (such as sitting more) sound like signs of pain. Do connect with the vet before giving any anti-inflammatory. This lets the vet choose which class of anti-inflammatories (NSAID or steroid) he prefers. Answers here: www.dodgerslist.com/literature/healingswelingANSWERS.htm |
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Post by Valerie & Lincoln on Oct 19, 2018 19:44:41 GMT -7
Quick update on Lincoln. Lincoln seems to be doing well. He is kennel resting almost done with week one now. I decided to go ahead and give me ✚rimidyl everyday along with his gaba and tramadol.
[Moderator's note: please do not modify
15 lbs
true crate rest only started as of 10/13
✚Rimadyl as of 10/17: 32 mgs 1x/day for how many days? then test for pain/neuro
gabapentin 100mgs 1x/day
tramadol 25mgs 2x/day]
He seems a lot better but I am being strict with he kennel rest and he seems happy. I wanted to get some insight from everyone for my little one. I have been thinking about purchasing some dog insurance for him while he is young and has no current medical issues. What are everyones thoughts? I have heard so many good and bad things about dog insurance, it isn't cheap and seems too good to be true in some cases but Kennedy is a dachshund as well and worry about IVDD with him in the future.
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Post by Pauliana on Oct 19, 2018 20:12:55 GMT -7
Hi Valerie,
The time to get pet insurance is before anything happens, so covering Kennedy wouldn't be a bad idea because he has no preexisting conditions.. The other option is starting a savings account in case Kennedy would develop IVDD or some other health related problem..
The experience I had with pet insurance with my Tyler who has IVDD.. I had him covered the year before he ever had his first episode but they refused to cover his disc surgery because his Vet told us that she thought he had Patellar Lunation,but the student Vet she thought it was IVDD the year before his episode happened and that was in his record so they wouldn't cover his surgery. I cancelled the policy..
I am so glad Lincoln is doing better..
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Post by Valerie & Lincoln on Oct 19, 2018 20:31:22 GMT -7
Yeah a savings account sounds like a better option because I have heard this from other people. The insurance companies find every reason to not cover issues. Thank you. Lincoln is happy and healthy for now, will update in a couple weeks.
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Marjorie
Moderator~ 
Member since 2011. Surgery & Conservative
Posts: 5,724 
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Post by Marjorie on Oct 20, 2018 6:28:00 GMT -7
Valerie, what is the dosage of the Rimadyl in mgs and frequency given? Was this given at the direction of the vet/neuro? For how many days has the Rimadyl been prescribed for? One of your postings mentioned that you had Prednisone and the neuro had said that might be an option. Just to be sure, Lincoln is only receiving the Rimadyl, correct? and not the Prednisone? It's very dangerous to give both Rimadyl and Prednisone at the same time - they need a 4-7 day washout period between giving.
Now that an anti-inflammatory is being given, Pepcid AC should also be given to protect Lincoln from the excess acid produced by the anti-inflammatory. The FDA and manufacturer pkg insert indicate gastrointestinal problems are side effects of using NSAIDs. The natural defenses of the stomach to shield against stomach acid is hindered when taking NSAIDs. Serious gastrointestinal toxicity such as bleeding, ulceration, and perforation, can occur at any time, with or without warning symptoms. Please get your vet's permission to give 5 mg of Pepcid AC (generic is famotidine) 30 minutes before the dose of the anti-inflammatory and thereafter every 12 hours. Phrase the question to your vet in this particular way: "Is there any medical reason my dog may not take Pepcid AC?" If your vet says your dog has no health issues such as liver, heart, etc to keep her from taking Pepcid AC, then do get it on board.
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Post by Valerie & Lincoln on Oct 21, 2018 7:06:54 GMT -7
His dose is half of a (75mg tablet) 32mg [Rimadyl] tablet once daily. I have given it a few days to see if it helped and it did. He has this prescription "as needed" from his vet. They did not say how many days I can give it when they gave me the prescription. I have a 60 day supply for his flare ups but I am going to cut the dose in half today to half of a half of the tablet (18mg) daily for a couple days then stop it, that how we did his dosing last time. Does that seem appropriate? I started the rimidyl Wednesday 10/17.
He has never got pepcid but I crush up the tablet and mix it in about 2 tablespoons-1/4 cup of milk. He likes milk and the vet says that milk should be fine. I know milk is a natural antacid but I'm not sure if that is enough.
I have the prednisone but I will not give it unless the neurologist tells me to. The prednisone was given to me prior to his surgery and then post his surgery they said he wouldn't need it unless he had another disc issue so I just have it in his medication pantry. I just wanted to add an anti-inflammatory med because of his back legs weakness and signs of pain. Over the last couple of days he seems much more comfortable. He is no long on the gabapentin, that dose ended 10/19. Still giving the tramadol 2 times daily. He has 2 more days left of the tramadol so it will end 10/23.
[Moderator's note: please do not modify
15 lbs
true crate rest only started as of 10/13
Rimadyl as of 10/17: 32 mgs 1x/day for how many days? then test for pain/neuro
gabapentin 100mgs 1x/day STOPPED 10/19
tramadol 25mgs 2x/day- to stop on 10/23]
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,539
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Post by PaulaM on Oct 21, 2018 7:47:46 GMT -7
Valerie, here is how an anti-inflammatory is used with a disc episode by vets who understand IVDD. 1. A vet must take a guess as to how long to used the Rimadyl anti-inflammatory drug. Often that guess will be maybe a 7-day course, maybe a 14-day course. Rimadyl will be expected to take anywhere in the range of 7 to 30 days to get all the painful swellilng down. 2. While Rimadyl is at work pain meds must be on board to provide comfort from pain. 3. Milk does not suppress the acids that Rimdayl causes. FYI: many dogs are lactose intollerant of milk products. Pepcid AC (famotidine) does suppress the extra acids that Rimadyl will cause. Here at Dodgers we have seen too many GI tract issues from not being proactive in protecting from increased stomach acids. Proactive STOMACH PROTECTION is the name of the game! Dogs don't speak up at first signs of trouble like a person would. By the time we notice black or red blood in the stools, things can quickly go from bleeding ulcers to a life threatening perforated stomach. Ask if your dog has any health issues to prevent use of Pepcid AC (famotidine)? (doesn’t need it, we wait til there is problem…are NOT answers to your question!) If you get a “no health issues” answer, then go to the grocery store to purchase over the counter Pepcid AC containing one single active ingredient (famotidine). The usual dose during a disc episode is Pepcid AC (famotidine) for dogs is 0.44mg per pound 30 mins before the anti-inflammatory and thereafter every 12 hours. Give the anti-inflammatory with a meal as added protection. www.1800petmeds.com/Famotidine-prod11171.html 4. Rimadyl is a non-steroid anti-inflammatory drug which DOES NOT required tapering. At the end of the course of Rimadyl is the time to be either backing of (this is your vet's call) of the meds that mask pain OR doing a full stop of the pain meds. Your job at home is to monitor for pain. Rule of thumb pain = swelling = another course of Rimadyl. Pain meds and Pepcid AC back on board5. It may be not be realistic to believe it is time to stop Rimadyl to test for pain today. He has just become comfortable, (out of pain) since starting Rimadyl on 10/17 (5 days ago) just in the last days
6. Please understand the term "flare up" is perhaps giving you the idea this is not a disc episode. This is a disc episode where Lincoln's disc has likely bulged out of shape due to many tiny little cracks (tears) on the surface of the disc. The tiny tears cause pain. As the disc pushes into the spinal cord area, it causes inflammation which is additional pain. Inflammation takes time to resolve.
Lincoln should not be short changed on his pain meds nor on his Rimadyl. Rimadyl with a disc episode it not used on an as needed basis and does not have the requirement to be tapered like a steroid would need to be! Pain meds stay on board until the stop of Rimadyl so that you truly, accurately and quickly assess for pain not yet fully resolved.
The treatment for this disc episode seems to be all over the place and not typical to how vets who know IVDD treat.
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Post by Valerie & Lincoln on Oct 21, 2018 8:54:34 GMT -7
I have never given Pepcid because the doctor never prescribed that. If I call the vet to add Pepcid they will want me to take him in and re-evaluate his pain needs because they just wanted a few days (vet never specified #days) of rimadyl. He was dosed with sucralfate 0.5 grams every 8 hours 9/20/18 for diarrhea from a stomach bug he had and that was for 6 days he ended that 9/27. This happened in conjunction to his disk issue so he was on this medication along with the gaba and tramadol.
[Moderator's note: please do not modify
15 lbs
9/20 disc episode, no crate rest
Rimadyl likely caused GI tract damage- treated with sucralfate.
true crate rest only started as of 10/13
Rimadyl as of 10/17: 32 mgs 1x/day for how many days? then test for pain/neuro
gabapentin 100mgs 1x/day STOPPED 10/19
tramadol 25mgs 2x/day- to stop on 10/23]
He doesn't have any health issues per her blood work. Is that what you are asking? He has never been on rimadyl longer than a week. He has drank milk since he was a puppy. He drinks the non-fat milk and has never had diarrhea or vomiting with it. I can look into the Pepcid and have it on hand for future rimadyl doses because giving it now after he already got it isn't going to do anything correct? This idea of medications for so long makes me want to stop them all together. I was happy the gaba was done and he is almost done with his tramadol but him being on medications so long term isn't good for him especially if he could now have intestinal issues. I do not usually take medications myself and I really struggle to give him medications because of all the adverse reactions and possible issues that arise from them but I do want him to be comfortable so I called to have a better plan but the vet says a few days and then re-evaluate seemed like a good idea. I really do not want to take him back to the vet for the 3rd time this month. They charge me $100 each time and usually don't tell me anything except to scan him again which is $4000 and that he isn't showing signs of pain. I am becoming very overwhelmed with the mixed recommendations. I also feel like they are just wanting me to pay more and don't really care about the well being of Lincoln. Plus I know it isn't a good idea to take him in the kennel to travel as well. I use the term "flare up" because he already had surgery that corrected the disc issue. This issue has occurred 3 months after surgery and he didn't have any other areas of concern on his scan 3 months ago so it is very unlikely it is another disk. Is this course of treatment appropriate for an injury of a post operative fixed disc? The reason the treatment is all over the place is because this is a new issue. Post operatively he was on strict instructions with medications and kennel rest for 8 weeks. I already did this, then he was cleared for movement and play and he suffered another injury. We DO NOT know what injury this is. possibly his pre-existing disc or another. So we have been taking it as it comes. initially it was 100mg gaba and 25mg tramadol and thats it. I asked about the anti-inflammatory per this blogs recommendation and they were hesitant to add it. I do not know why. ANIC is a highly recommended place and its the only neurology center in the state so I do not have other options. The tapering of the rimadyl is to re-evaluate his pain and ensure he isn't in pain with the decrease in meds that way some is still on board. I have a vet as well as a neurologist and these are meds from both doctors so the as needed rimadyl is from the vet and the tramadol and gaba is from the neuro doc.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,539
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Post by PaulaM on Oct 21, 2018 12:01:05 GMT -7
Valerie, I am sorry you are getting confusing information. It is tough when one is not yet up to speed on IVDD---hard to ask the right questions, hard to know if the treatment is a good one--- definately puts you in having to blindly follow along and limits abilities to be an advocate for Lincoln you'd want to be. None us here are veterinarians. Since 2002 Dodgerslist has been observing how vets treat a disc episode in an effort to figure out why some dogs have GI tract damage and have died from bleeding ulcers (no Pepcid AC!), why they relapse in the middle of treatment (often incomplete crate rest.) What some neuros and other veterinary professionals comment about Dodgerslist: www.dodgerslist.com/index/education.htm Here on the Forum we have been able to see a pattern all these many years and over the course of some 10,000 dogs what the successful vets do. In addition, Dodgerslist consults several boarded neuro surgeons to help us understand the unusual cases here and there. That is what we have to share with you to help you make sense of your dog's journey with a disc episode and to better work with the IVDD vet you have chosen to be on Lincoln's heath care team. Some DVM vets know alot about IVDD and others not as much as they know about other diseases. Your job, when you have gotten up to speed, is to be able to identify which vets are which. The goal of our Forum is to support you, to teach you how to learn to look up things, question everything and read so you become the most important part of your dog's health care team. By doing your own reading, making your own notes, your own list of questions, you OWN future conversations with your vet. Your vet will understand why you are hiring them, what your financial situation is re: treatments, surgery, etc. You become the captain of the health care team. So naturally you will want to be an integral part of making decisions and work closely with the vet you have hired. Dr. Nancy Kay, DVM, ACVIM highly recommends this kind of relationship with your vet: " Gone are the days when you simply followed your vet's orders and asked few, if any questions. The vet is now a member of your dog's health-care team, and you get to be the team captain!" www.speakingforspot.com/PDF/Medical%20Advocacy%20101.pdfConservative treatment does not necessarily require the consult of a neuro surgeon. There are many general DVM vets who know it well. The issue is to make sure you have hired a general DVM vet who does. IF you are not getting the help you need, because a vet is not comfortable in their IVDD knowledge, then a consult with a neuro certainly is a good idea in getting the right meds on board a local vet may not be used to using. A disc episode is nothing to fool around with lack of appropriate aray of the necessary high powered pain meds nor the correct use of an anti-inflammatory drug. The spinal cord is delicate. Weighing the tragic risk of permanent spinal cord damage vs. the use of appropriate meds used ONLY until all the benefit has been gained makes sense.
---- The anti-inflammatory benefit is resolution of all pain.
-----Neuro deficits is something the body heals...no meds heal nerve damage.
----- All meds have adverse side effects. The safety is in a vet who uses meds in a safe manner AND an owner who has read to know what each med does, what to monitor, for and actions to take. The idea is to get that swelling around the cord down soonest possible, not delay with low doses, too short of Rimadyl course. When one has under their belt the processes it is not rocket science but a matter of observing and letting the signs guide the course of meds. SIGNs guiding the treatment on the test stop of Rimadyl + pain meds Pain= another course of anti-inflammatory + all pain meds back on board + acid suppressor Pepic AC.
No Pain= no need of any meds...just finish out the 8 weeks of crate rest for the disc to heal.The full details on how Rimadyl, an anti-inflammatory works with a disc episode. Good reading to be able to ask the right questions and discuss treatment: www.dodgerslist.com/literature/healingsweling.htmPepcid AC works in 30 mins. to reduce the acids Rimadyl causes. From what you report it is your neuro's call to back off of the pain meds to avoid rebound pain at the FULL STOP of your DVM's Rx of Rimadyl . -- Rimadyl does not require backing off (tapering) as would a steroid hormone like prednisone -- Your job at home is to observe for pain as the pain masking pain meds are lessening while Rimadyl has come to a full stop. Any sign of pain, then all meds need to be back on board including the all important acid reducer Pepcid AC. On Oct 23 when the last tramadol will be stopped, you would then have full final proof if there is no pain and no more need of any med. Let us know when Rimadyl will be fully stopped as the pain meds are already being lessened as per the neuro! You would want to have the speediest of test results to know if another course of Rimadyl is needed or not. The adjustment of another course of Rimadyl/pain meds would be by calling in and reporting signs of pain/new neuro issues to avoid a risky to the disc transport. |
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Post by Valerie & Lincoln on Oct 21, 2018 17:19:47 GMT -7
Thank you for all the support and information. I have contacted ANIC and as I thought they want me to take him back in for a re-evaluation. They do not think he should still be needing pain medications. I can’t get an appointment this week because they only have afternoon appointments and I work till 5 or 6pm so I am almost out of meds I just have the rimadyl. I will stop and get some Pepcid today so I can give it to him prior to giving the rimadyl. They wouldn’t even give me recommendations over the phone without evaluating him so I did not get an approval for the Pepcid. I can try to contact my vet but they work closely with my neurologist and I know they too will want to re-evaluate him prior to giving the Okay for medications. This is the overwhelming part. I trust what the blog says and I think you guys have the most experience given the background of the program. However, it is difficult for me to go rogue and just give Lincoln what I think he needs when the vet wants to re-evaluate him constantly. At this point I don’t have many options. I can continue what I am doing and give the medications and kennel rest until I can go in for an appointment or I can discontinue everything and just kennel rest him and see how he does then go for an appointment. Either way I don’t feel good about the options but I don’t have a choice.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,539
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Post by PaulaM on Oct 21, 2018 17:41:48 GMT -7
Call your own DVM vet and just ask, if Lincoln has any health issues to keep him from Pepcid AC (famotidine) Here is the quote again by the Mar Vista vets: Mar Vista Vet reports: Pepcid AC has a very limited potential for side effects, the reason of release to over-the-counter status. The dose of famotidine may require reduction in patients with liver or kidney disease as these diseases tend to prolong drug activities. There have been some reports of exacerbating heart rhythm problems in patients who already have heart rhythm problems so it may be prudent to choose another means of stomach acid control in heart patients. marvistavet.com/famotidine.pml North Carolina U. recognizes the high incidence of GI irritation in dogs with disc problems. The reasons are that pain and body changes are stresses. Just as humans can experience ulcers when under stress. NCU and 11+ hospitals working with NCU prescribe a GI protectant. Dogs presented to NCU with IVDD often develop GI upset whether they are given anti-inflammatory medications or not. www.cvm.ncsu.edu/vhc/tc/clinical_services/neuro/acute_disc.html== Stuart Clark-Price, DVM, MS, DACVIM, DACVA explanation supports the need to be proactive in GI tract protection: "The gastrointestinal tract is by far the most common site of NSAID toxicity (DeNovo, 20030. Adverse gastrointestinal events reported in dogs, cats, and horses range from mild inflammation to catastrophic ulceration and death (Hough et al., 1000, Lascelles et al., 2005a; Lascelles etalk 2007).... Gastronintestinal lesions caused by NSAIDs in dogs tend to be located in the Pyloric antrum, and have a poor prognosis if not identified and treated early (Lascelles et al., 2005a) Pain Management in Veterinary Practice. edited by Christine M. Egger, Lydia Love, Tom Doherty "Nonsteroidal Anti-inflammatory Drugs and Corticosteroids". Wiley Blackwell, 2014 == "The use of a GI tract protectant in cases that are receiving NSAID's or steroids would definitely be warranted under the supervision of the patient's veterinarian." Dr. Andrew Isaacs, DVM Diplomate ACVIM (Neurology) Dogwood Veterinary Referral Center www.dodgerslist.com/neurocorner2/stomachProtection.htmHas your own vet then pretty much indicated he does not feel comfortable with IVDD and has referred you to ANIC and the two neuro (ACVIM) surgeons there? IF you have the support of your DVM of stopping Rimadyl and the continued backing off of pain meds, THEN, then IF, if pain would surface, your vet could be called to alert about the pain signs and Rx another course of Rimadyl plus all meds back on board. Otherwise if you have no local vet who knows IVDD, you would continue meds til you can get in for the more expensive ANIC neuro consult appointment...leaving Lincoln in pain if it is not being fully managed currently...not a prudent thing to do. Does your local DVM vet know about your financial limitations? |
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Post by Valerie & Lincoln on Oct 21, 2018 19:16:53 GMT -7
My vet did refer me to neurology for his pain management when I took him in. I will call to speak to Dr Parker his vet and see what she says. I will continue what meds I have until I can get him an appointment and I will add the Pepcid if cleared by my vet.
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Post by Valerie & Lincoln on Oct 22, 2018 20:12:35 GMT -7
I made an appointment for Lincoln on 10/25, they wouldn't prescribe him meds otherwise. I am going to hold him on the way and have a friend drive us that way he doesn't have another injury from the travel. I am going to bring forward all the concerns I have had along with the recommendations from dodgerlist. I will update as soon as I know more. I will stop all medications tomorrow so they can assess him accurately and start the washout incase he needs to go on a steroid, he isn't showing signs of pain right now and I hope it stays that way but if he does have the signs at least we can get him the right treatment and medications. I will have them add a pepcid AC as well. Thank you for all your help.
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Post by Pauliana on Oct 22, 2018 21:16:49 GMT -7
For transport to necessary Vet visits, please pad out the carrier or crate extra space with a rolled up towel/blanket to prevent body shifts during braking or cornering. Holding him in the car is not a good idea, his back needs to be kept straight and level.. To this day we still take Tyler in a carrier when taking him in the car, that is the safest way with a dog with IVDD.
I hope the visit with the neuro will get him on the right medications and be more helpful to you and Lincoln.
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Post by Julie & Perry on Oct 23, 2018 1:19:21 GMT -7
If you need to switch from an nsaid, like rimadyl, to a steroid, there is typically a washout period.
However, in an emergency, it can be done without a washout period if your dog takes two stomach protectors called pepcid ac and sulcrafate.
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